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    #1

    Eschenbach #34 tint?

    Has anyone ever heard of an Eschenbach 34 tint? One of the Ophthalmologists from a Low-Vision clinic inside our hospital wrote it on an RX and I'd never heard of it before and can't find any reference to it online. I know Eschenbach makes pre-tinted purply FL41 glasses and maybe that's what he meant but I wanted to see if anyone else had heard of it.

    Do purple/FL41 tints even help with low-vision? I found this old Opti board thread (linked below) but didn't find anything definitive.
    Tinted Lenses post Brain Injury - OptiBoard Discussion Forums
    https://www.optiboard.com
    Colleagues, There is very little literature on this topic and every optometrist (and I suspect optician) who encounters these patients has an opinion (sometimes a strong one) on this issue. FL-41 lenses have some (limited) mention in the headache literature. For those who are inclined to include tint in lenses for post-brain
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    #2
    Eschenbach Tint Correlation - 2022​

    Maybe Dr is referencing this chart
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      #3
      Well now I feel dumb because I definitely found that chart during my googling but only just now noticed it has little numbers next to each tint.

      So it looks like it is an FL41 rose 25% (I'm assuming that's the transmission rate so a 75% rose tint)

      I know fl41 is supposed to help with migraines but does it do anything for low vision?

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        #4
        i could see the rose tint helping out with the contrast and colors for low vision patients, it would be kinda like wearing a rose sunglass full time
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          #5
          i could see the rose tint helping out with the contrast and colors for low vision patients, it would be kinda like wearing a rose sunglass full time

          oops, didnt mean to double post :(

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            #6
            The overwhelming % of doctors prescribing FL-41 have no idea what they're doing / asking for. They never do any clinical testing w their patients, and equally never prescribe a clinically relevant density. Worse still, they usually have no meaningful discussion w their patients about what that actually looks like in their lenses, nor reasonable expectations of what it may or may not accomplish in the real world. The reality is, none of us today are working under the sickly greenish fluorescent tubes, and ancient flicker-prone CRT monitors of the mid 80's - when that specific color was created. Yet prescribers continue to write it 40 years on.

            Serge, I'd be having a frank discussion with that MD about both the tint, and the density they're prescribing. Also worth asking about their intended follow-up care after initial dispense, to help avoid the almost inevitable remake(s). To be clear, regardless of what Eschenbach shows there, as "Rose" tint is absolutely not an "FL-41" tint. They are different animals altogether. Though a 25% transmission is close to a clinical density for a proper FL-41.

            Does the pt know they're getting [essentially] sunglasses?



            Now if they'd do it properly and script it with an Ultex lens - that I could get behind!

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              #7
              Originally posted by Uilleann View Post
              The overwhelming % of doctors prescribing FL-41 have no idea what they're doing / asking for. They never do any clinical testing w their patients, and equally never prescribe a clinically relevant density. Worse still, they usually have no meaningful discussion w their patients about what that actually looks like in their lenses, nor reasonable expectations of what it may or may not accomplish in the real world. The reality is, none of us today are working under the sickly greenish fluorescent tubes, and ancient flicker-prone CRT monitors of the mid 80's - when that specific color was created. Yet prescribers continue to write it 40 years on.

              Serge, I'd be having a frank discussion with that MD about both the tint, and the density they're prescribing. Also worth asking about their intended follow-up care after initial dispense, to help avoid the almost inevitable remake(s). To be clear, regardless of what Eschenbach shows there, as "Rose" tint is absolutely not an "FL-41" tint. They are different animals altogether. Though a 25% transmission is close to a clinical density for a proper FL-41.

              Does the pt know they're getting [essentially] sunglasses?



              Now if they'd do it properly and script it with an Ultex lens - that I could get behind!
              Ok so there is some more context to this story: The patient did have a pair of deep purple tinted lenses made by our office previously (before I was there). When I double checked the RX, the instructions said "Eschenbach 34 tint but double check" which tells me the MD wasn't prescribing the tint so much as trying to guess what she had currently and then writing in on the RX, which honestly, I don't know why they wouldn't just write "match tint" in that case. Not that it mattered because the patient felt their old ones were not dark enough so there was a little bit of back and forth between us, the patient, and the lab trying to figure out what to put on the order.

              I was not the optician who started with the patient, the other optician who was working with the patient came back on my lunch break to ask me what an "eschenbach 34" tint was which sent me on this rabbit hole of trying to figure out what this magical tint that fixes low vision is (only to find out it was just the MD guessing).

              I almost went down another Rabbit Hole looking up Ultex lenses because of your comment but thankfully found an Optiboard thread from 2002 where everyone was saying they hadn't seen one in 10+ years, so I was at least able to gather you were joking, lol.

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                #8
                Hehehe - yep. Ultex is oooooold. FL-41 is too.

                This is the trouble I often run into with MDs [in particular, but also some ODs] When it comes to much of this area of practice, they're just wildly guessing at best most of the time. But without any initial clinical testing, nor indeed any follow up care.

                Best of luck in sleuthing this one out. You're asking the right questions, and you may want to have a frank discussion with your pt about limiting remakes etc if they don't love the new lenses. And of course, chart e-v-e-r-y-t-h-i-n-g, so if you're lucky enough to have to this again in future, at least you'll have some breadcrumbs to help. Cheers!
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                  #9
                  i worked for an OD a number of years ago who prescribed FL-41 for use during migraines. i am a migraine sufferer myself, and have made my general use sunglasses an FL-41 3 since working at that office, and can report that they are quite nice to wear in the midst of a migraine -- it negates much of the impulse to close your eyes tightly and curl up in the corner of a dark closet, makes it almost bearable to have your eyes open. some of my patients wear FL-41 full time and have anecdotally reported that it reduces the occurrence of migraines, but i don't know if i buy that. that is the only valid purpose i can imagine FL being prescribed for.

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